Overview

• Nephrotic Syndrome → collection of signs and symptoms indicating damage to the glomerular filtration barrier. Characterised by massive proteinuria, hypoalbuminaemia and oedema.

Causes:

• Minimal Change Disease (Primary)
• Membranous Glomerulonephritis (Primary)
• Focal Segmental Glomerulosclerosis (Primary)
• Diabetic Nephropathy (Secondary)
• Amyloid Nephropathy (Secondary)

Making Diagnosis

Clinical Features:

• Massive Proteinuria >3.5g/24 hours → may cause foamy urine
• Oedema → starts with periorbital oedema, then may lead to peripheral oedema (or pulmonary oedema)
• Hypoalbuminaemia (<25 g/L)
• Hyperlipidaemia → low blood protein increases lipid synthesis
• Hypercoagulable State → increased risk of thrombosis. Due to loss of antithrombin III (also protein C and protein S) and rise in fibrinogen levels.
• Increased Risk of Infection → due to loss of immunoglobulins